The purpose of this proposal is to summarize the resources at Magee Womens Hospital of the University of Pittsburgh Medical Center (UPMC) and to demonstrate how we will contribute meaningfully to the mission and objectives of the NICHD-sponsored Maternal- Fetal Medicine Units Network. Our Unit has been an active participant in single- and multi-center observational and interventional clinical studies for three decades, including the NuMom2b network, and the Obstetric-Fetal Pharmacology Research network, and previous iterations of the MFMU Network. Our track record establishes that we have demonstrated our willingness to cooperate with other institutions and the NICHD in the development and implementation of clinical research protocols. We have been active participants in every aspect of multicenter networks. We have proposed protocols, have served on subcommittees of other protocols, have served on administrative subcommittees, and have served as site visitors to evaluate other centers. We have effectively recruited patients and have provided intellectual input in the development of new projects as well as the implementation of protocols from our center and from others. The obstetrical unit at the University of Pittsburgh is one of the largest private academic obstetrical services in the United States with over 10,000 deliveries annually. Approximately 40% of our patients are deemed to be high risk prior to labor. The demography of our population, detailed in this application, and our high enrollment rates help ensure that results of Network studies are widely applicable across a diverse spectrum of subjects. In this proposal we will: (1) describe our experience, infrastructure, and track record o participation in single-center and multicenter studies of adverse pregnancy outcome; (2) demonstrate our ability to enroll and provide maternal and newborn follow-up to subjects enrolled in MFMU trials; and (3) delineate our unique suitability in terms of technical and multidisciplinary content expertise to address the objectives of the MFMU Network. We are enthusiastic about contributing to the success of the MFMU Network and its continued pre-eminence in clinical research